冠心病患者生活质量现状及其相关影响因素分析

Assessing quality of life among patients with coronary heart disease

目的：采用简易健康量表SF-12与欧洲五维度健康量表EQ5D评估冠心病患者的生活质量,进一步分析探讨其与影响因素包括年龄、性别、血清B型脑钠肽（BNP）水平、左室射血分数（LVEF）及NYHA心功能分级的相关性。方法：收集2007-08-2010-01在南昌大学第二附属医院心内科住院的330例数据完整且获得随访的冠心病患者,对其进行电话随访并完善量表SF-12以及EQ5D的填写。分别将SF-12总分、躯体健康总评（PCS）得分、精神健康总评（MCS）得分、EQ5D指数得分、EQ5D-VAS得分结合冠心病患者的年龄、性别、BNP、心功能分级和LVEF进行分析。结果：冠心病患者SF12生活质量总分（96.64±14.47）、PCS评分（43.89±10.24）、MCS评分（52.75±6.53）以及EQ5D指数得分（0.86±0.15）、EQ5D-VAS得分（77.47±13.78）,年龄、BNP水平、NYHA心功能分级对生活质量的影响具有统计学意义,而LVEF仅对SF-12、PCS、EQ5D-VAS评分有影响,对MCS与EQ5D评分的影响无统计学意义;男性各项生活质量评分均数高于女性,且在SF-12、MCS、EQ5DVAS这3项得分差异具有统计学意义（P〈0.05）。简表SF12与EQ5D的评分结果呈显著相关（P〈0.01）,相关系数在0.520~1.000。结论：年龄、BNP水平及心功能分级是影响冠心病患者生活质量的重要因素,并与性别差异密切相关。生活质量量表SF-12以及EQ5D在评价冠心病患者的生活质量时效果一致。

Objective：To evaluate the quality of life（QOL）among patients with coronary heart disease and to examine the correlation of QOL with influence factors like age,sex,serum Brain Natriuretic Peptide（BNP）,left ventricular ejection fraction（LVEF）and Heart function grade of NYHA.Method：Clinical data were obtained retrospectively from medical records of 330patients admitted to the Second Affiliated Hospital of Nanchang University with diagnosis of coronary heart disease from August 2007to January 2010.Telephone interviews were made to administer the Short Form-12（SF-12）and the EuroQol-5 dimensions（EQ5D）.Complete information was obtained from 330patients and analyzed.Result：The mean SF-12score（96.64±14.47）,Physical Component Summary（PCS）-12score（43.89±10.24）,the mean Mental Component Summary（MCS）-12score（52.75± 6.53）,the EQ5Dscore（0.86±0.15）and EQ5D-VAS score（77.47±13.78）in CHD patients.Age,serum BNP level,heart function grade of NYHA had significant correlation with QOL,while,LVEF affect the score of SF12,PCS and EQ5D-VAS,but not the score of MCS and EQ5D.Compared with men,women had lower QOL scores,significant difference were obsereved on the score of SF-12,MCS and EQ5D-VAS（P0.05）.The scores showed a significantly negative correlation between SF12and EQ5D,（correlation index was 0.520~1.000）.Conclusion：The QOL among patients with coronary heart disease appears to be influenced by the factors including age, BNP and NYHA classification.The use of EQ5Dquestionnaire allows the same information to be obtained as from the SF-12while assessing the QOL among coronary heart disease patients.